No abstract available.
Crohn Disease/*drug therapy/*metabolism ; Female ; Forkhead Transcription Factors/*metabolism ; Gastrointestinal Agents/*therapeutic use ; Humans ; Infliximab/*therapeutic use ; Leukocytes, Mononuclear/*metabolism ; Male ; Membrane Proteins/*metabolism ; beta-Defensins/*metabolism

BACKGROUND/AIMS: Hyperglycemia is associated with decreased 2-18[F]fluoro-2-deoxy-D-glucose (FDG) uptake by tumors assessed by positron emission tomography (PET). In this retrospective study we investigated a comparison of standardized uptake values (SUVs) in patients with primary colorectal cancers who either had diabetes mellitus (DM) or were otherwise healthy. METHODS: The medical records of 397 patients who were diagnosed with colorectal cancer and underwent PET-CT between January 2006 and December 2012 were analyzed. Eighty patients with DM and 317 patients without DM were included. Clinical characteristics were reviewed and maximal standardized uptake values (SUVmax) were calculated in the primary colorectal lesions. RESULTS: There was no significant difference between tumor SUVmax in DM patients (10.60+/-5.78) and those without DM (10.92+/-5.44). In addition, no significant difference was detected between tumor SUVmax in DM patients with glycated hemoglobin (HbA1c) levels <8% (10.34+/-5.17) and those with HbA1c levels > or =8% (10.61+/-7.27). The maximum size of the primary colorectal tumor was associated with SUVmax in a linear regression analysis. CONCLUSION: The results of this study showed that DM did not influence FDG uptake values in colorectal cancer patients regardless of glucose levels.
Colorectal Neoplasms* ; Diabetes Mellitus* ; Glucose ; Hemoglobin A, Glycosylated ; Humans ; Hyperglycemia ; Linear Models ; Medical Records ; Positron-Emission Tomography* ; Retrospective Studies

BACKGROUND/AIMS: The aim of this study was to investigate the role of psychosocial problems and their associations with rotating shift work in the development of functional gastrointestinal disorders. METHODS: In this cross-sectional observation study, survey was administered to nurses and nurse assistants in a referral hospital. In addition to demographic questions, subjects were asked to complete the Rome III Questionnaire, Pittsburgh Sleep Quality Index and Rome III Psychosocial Alarm Questionnaire. RESULTS: Responses from 301 subjects were assessed. The overall prevalence of irritable bowel syndrome (IBS) and functional dyspepsia (FD) were 15.0% and 19.6%, respectively. Psychosocial alarms were prevalent in the nursing personnel (74.8% with alarm presence and 23.3% with serious condition) and were more frequent among rotating shift workers (84.7% vs. 74.5% for alarm presence and 28.1% vs. 13.3% for serious condition). The prevalence of both IBS and FD significantly increased with psychosocial risk. An independent risk factor for IBS was serious psychosocial alarm (adjusted odds ratio [aOR], 10.75; 95% confidence interval (CI), 1.30-88.99; P = 0.028). Serious psychosocial alarm was an independent risk factor for FD (aOR, 7.84; 95% CI, 1.98-31.02; P = 0.003). Marriage (aOR 0.30; 95% CI, 0.09-0.93; P = 0.037) was associated with the decreased risk of FD. CONCLUSIONS: The high prevalence of psychosocial stress among nurses who work rotating shifts is associated with the development of functional gastrointestinal disorders.
Appointments and Schedules* ; Dyspepsia ; Gastrointestinal Diseases* ; Irritable Bowel Syndrome ; Marriage ; Nursing ; Odds Ratio ; Prevalence ; Surveys and Questionnaires ; Referral and Consultation ; Risk Factors

The causes of pyogenic liver abscess has been known as biliary tract disease or intrabadominal infection but the large proportions of the patients has no apparent underlying disorders. Recently colonic mucosal lesions were reported in patients with cryptogenic liver abscess and it has been suggested that colonic mucosal break may play a role in developing liver abscess in otherwise healthy patients. We experienced a patient of severe recurrent liver abscess complicated with endophthalmitis only 3 months after successful treatment of initial cryptogenic liver abscess and a polypoid colon cancer was discovered by chance. It seems prudent to proceed colonoscopic examination in patients with cryptogenic liver abscess especially when it is recurrent.
Biliary Tract Diseases ; Colon ; Colonic Neoplasms ; Endophthalmitis ; Humans ; Klebsiella pneumoniae ; Liver ; Liver Abscess ; Liver Abscess, Pyogenic ; Recurrence

A gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract and expresses CD117, a c-kit proto-oncogene, which can be detected immunohistochemically. We reported a GIST of the rectum of a 61-year-old-woman who had visited emergency room complaining of constipation over one week. Upon rectal examination, a round hard mass was palpated. Colonoscopy showed a 7x5 cm sized protruded lesion with surface ulceration on a rectum, adjacent the anus. And abdomen computed tomography revealed the soft tissue mass compressing anterolateral wall of the rectum and these findings suggest possibility of rectal submucosal tumor such as GIST. The patient had been treated with a ultra anorectal anastomosis with loop ileostomy. Immunohistochemical studies on the surgically resected specimen showed c-kit (+) and CD34 (+). The final diagnosis was a GIST of the rectum. She was grouped into high risk and she has been given adjuvant chemotherapy with Imatinib.
Abdomen ; Anal Canal ; Benzamides ; Chemotherapy, Adjuvant ; Colonoscopy ; Constipation ; Emergencies ; Gastrointestinal Stromal Tumors ; Gastrointestinal Tract ; Humans ; Ileostomy ; Piperazines ; Proto-Oncogenes ; Pyrimidines ; Rectum ; Ulcer ; Imatinib Mesylate

Thromboembolic events are rare among systemic complications of inflammatory bowel disease; however, they are a significant cause of mortality when they occur. Several reports have considered thromboembolic events in patients with ulcerative colitis presenting with venous or arterial thromboembolism, such as cerebral thrombosis, deep vein thrombosis, pulmonary thromboembolism, portal vein thrombosis, or mesenteric vein thrombosis. However, increased coagulability related to Crohn's disease is extremely rare compared with that of ulcerative colitis. We report a case of a 42-year-old man with complicated portal hypertension that occurred due to extensive portal vein and mesenteric vein thrombosis. He had a monozygotic twin brother who was also in remission with Crohn's disease. The patient showed protein C and protein S deficiencies; however, he recovered with early anticoagulation therapy.
Colitis, Ulcerative ; Crohn Disease ; Humans ; Hypertension, Portal ; Intracranial Thrombosis ; Mesenteric Veins ; Portal Vein ; Protein C ; Protein S ; Pulmonary Embolism ; Siblings ; Thromboembolism ; Thrombosis ; Twins, Monozygotic ; Venous Thromboembolism ; Venous Thrombosis

Sunitinib an inhibitor of the vascular endothelial growth factor receptor, is highly effective against renal cell carcinoma and is now widely used in patients with metastatic disease. Gastroesophageal reflux disease (GERD) is rarely reported as a side effect of sunitinib. We report two cases of GERD with upper gastrointestinal bleeding related to sunitinib administration. Both cases responded well to conservative management. Microscopic findings in both cases showed cellular atypia such as hyperchromasia, increases in nuclear size, and multinucleation. The cellular atypia of the squamous mucosa appears to be associated with reparative processes.
Carcinoma, Renal Cell ; Esophagitis, Peptic ; Gastroesophageal Reflux ; Hemorrhage ; Humans ; Indoles ; Mucous Membrane ; Pyrroles ; Receptors, Vascular Endothelial Growth Factor

BACKGROUND/AIMS: Non-alcoholic fatty liver disease is associated with insulin resistance. Compound K (CK) is the final metabolite of panaxadiol ginsenosides that have been shown to exert antidiabetic effects. However, the molecular mechanism of the antidiabetic effects in the liver have not been elucidated; further, whether CK has beneficial effects in hepatosteatosis remains unclear. Therefore, we evaluated the effect of CK on hepatosteatosis as well as its mechanism in high-fat diet (HFD)-fed type 2 diabetic Otsuka Long-Evans Tokushima Fatty (OLETF) rats. METHODS: Twenty-four-week-old male OLETF rats were assigned to four groups: control (saline), CK 10 mg/kg, CK 25 mg/kg, or metformin 300 mg/kg (positive control); all treatments were administered orally for 12 weeks. RESULTS: Fasting glucose levels of the CK25 group were significantly lower than those of the control group during the 12 weeks. The results of the oral glucose tolerance test showed that both the glucose concentration after glucose loading and the fasting insulin levels of the CK25 group were significantly lower than those of the control. Hepatosteatosis was significantly improved by CK25. CK25 and metformin significantly increased the phosphorylation of hepatic adenosine monophosphate-activated protein kinase (AMPK). CK25 significantly inhibited the expression of sterol regulatory element-binding protein-1c and fatty acid synthase, while upregulating that of peroxisome proliferator-activated receptor-α and carnitine palmitoyltransferase-1. CONCLUSIONS: CK improved glucose intolerance and hepatosteatosis in HFD-fed OLETF rats through AMPK activation, which has dual mode of action that involves decreasing the synthesis of fatty acids and increasing fatty acid oxidation.
Adenosine ; AMP-Activated Protein Kinases ; Animals ; Carnitine ; Diabetes Mellitus, Type 2 ; Diet, High-Fat ; Fasting ; Fatty Acids ; Ginsenosides ; Glucose Intolerance* ; Glucose Tolerance Test ; Glucose* ; Humans ; Insulin ; Insulin Resistance ; Liver ; Male ; Metformin ; Non-alcoholic Fatty Liver Disease ; Peroxisomes ; Phosphorylation ; Protein Kinases ; Rats ; Rats, Inbred OLETF*

OBJECTIVES: The purpose of this study was to establish a basis for improving or strengthening the preventive strategy against scrub typhus in Korea by comparing and analyzing the difference of prevention behaviors contributing to the occurrence of scrub typhus in Japan and Korea.METHODS: The survey was carried out in Jeollabuk-do, which is a high risk and high incidence area, and Fukuoka Prefecture, which is a high risk and low incidence area. The study included 406 Korean farmers and 216 Japanese farmers. Data were collected through face-to-face surveys by interviewers who had completed standardized education.RESULTS: Korean farmers have a higher percentage of agricultural working posture that involved contact with weeds than Japanese farmers (p < 0.05). The frequency and proportion of weeding were lower in Korean farmers than in Japanese farmers (p < 0.05). The level of knowledge about scrub typhus was significantly higher among Korean farmers than among Japanese farmers (p < 0.05). Mostly, the behavior of agriculture work was more appropriate for Japanese farmers than for Korean farmers (p < 0.05). The total average level of agricultural work was lower in Korea than in Japan, lower in men than women, and lower in part-time farmers than full-time farmers (p < 0.05).CONCLUSIONS: This study suggests that it is reasonable to develop and provide a program that can improve the level of preventive behavior taking into consideration the characteristics of the subject in order to reduce the incidence of diseases in high-risk areas for scrub typhus.
Agriculture ; Asian Continental Ancestry Group ; Education ; Farmers ; Female ; Humans ; Incidence ; Japan ; Jeollabuk-do ; Korea ; Male ; Posture ; Scrub Typhus

OBJECTIVES: The purpose of this study was to establish a basis for improving or strengthening the preventive strategy against scrub typhus in Korea by comparing and analyzing the difference of prevention behaviors contributing to the occurrence of scrub typhus in Japan and Korea. METHODS: The survey was carried out in Jeollabuk-do, which is a high risk and high incidence area, and Fukuoka Prefecture, which is a high risk and low incidence area. The study included 406 Korean farmers and 216 Japanese farmers. Data were collected through face-to-face surveys by interviewers who had completed standardized education. RESULTS: Korean farmers have a higher percentage of agricultural working posture that involved contact with weeds than Japanese farmers (p < 0.05). The frequency and proportion of weeding were lower in Korean farmers than in Japanese farmers (p < 0.05). The level of knowledge about scrub typhus was significantly higher among Korean farmers than among Japanese farmers (p < 0.05). Mostly, the behavior of agriculture work was more appropriate for Japanese farmers than for Korean farmers (p < 0.05). The total average level of agricultural work was lower in Korea than in Japan, lower in men than women, and lower in part-time farmers than full-time farmers (p < 0.05). CONCLUSIONS: This study suggests that it is reasonable to develop and provide a program that can improve the level of preventive behavior taking into consideration the characteristics of the subject in order to reduce the incidence of diseases in high-risk areas for scrub typhus.
Agriculture ; Asian Continental Ancestry Group ; Education ; Farmers ; Female ; Humans ; Incidence* ; Japan* ; Jeollabuk-do ; Korea* ; Male ; Posture ; Scrub Typhus*